Intake Of Painkillers Research Articles

Prevalence of Chronic Kidney Disease in a High-Risk Population in Urban Lahore, Pakistan: A Cross-sectional Study.

Background Chronic kidney disease (CKD) is a globally increasing health concern, and there is a growing focus on early screening and prevention efforts. However, the availability of data on CKD prevalence in Pakistan, particularly in the urban area of Lahore district, is limited. The objective of the Kidney Early Evaluation Program (KEEP) Lahore was to assess the prevalence of CKD in a high-risk population residing in the urban area of Lahore, Pakistan. Methods A cross-sectional study was conducted involving 254 participants, who were over 18 years old and belonged to a high-risk population according to the pre-defined operational definitions. The participants were randomly selected from various towns in Lahore. Screening camps were set up to measure serum creatinine levels and urinary albumin to creatinine ratio (UACR), and then the estimated glomerular filtration rate (eGFR) was calculated using the CKD Epidemiology Collaboration 2021 (CKD EPI) equation. Results Out of the total 254 participants, a diagnosis of CKD was made in 62 (24.2%) individuals. Significant associations were found between CKD and risk factors including hypertension, diabetes, family history of CKD, ischemic heart disease (IHD) or congestive heart failure (CHF), intake of painkillers, and herbal medicines. However, no association was found between obesity (BMI ≥30) and CKD. Participants diagnosed with CKD had a mean age of 49.9 years and a mean serum creatinine level of 1.2 mg/dL, while non-CKD participants had a mean age of 43.7 years and a mean serum creatinine level of 0.7 mg/dL. Conclusion Our study revealed that CKD was prevalent in about one-fourth of the participants from the high-risk population of Lahore, indicating a high prevalence of the disease within society. Moreover, hypertension, diabetes, family history of CKD, heart disease, painkillers, and the use of herbal medicines were all significantly linked to CKD in the surveyed sample population.

Painkiller intake and problematic health literacy in sport and music students - A cross-sectional study

Previous works have suggested a high prevalence of painkiller intake (PI) among sport students but also improved health literacy (HL) for sports-active students than for sports-inactive students. Since health-related content also forms part of the sport science curriculum, the study focuses on these seemingly paradoxical results. Music students who are also physically active through their instrumental practice, who act in an area with increased PI and who have no health-related teaching content in their curriculum composed the comparison group. Therefore, this study investigated the prevalence of PI and HL in cohorts of sport (n = 222; 54.5% female) and music students (n = 89; 67.4% female) using a cross-sectional online survey in Lower Saxony, Germany. The hypothesis tests were validated by calculating frequentist and Bayesian statistics. The results show that 50.9% of sport and 28.1% of music students exhibit PI concerning their study programs, often for prophylactical purposes and in the presence of low HL levels. The weak negative correlation between PI and HL was not statistically confirmed and requires further research with improved test power. Regarding the possible health consequences of an inconsiderate PI, target group-specific prevention is indicated to increase general health awareness and HL.

Low Post-Treatment Quality of Life and the High Incidence of Pain Are Common and Significantly Exacerbated in Depressed Head and Neck Patients Treated with Definitive Accelerated Radiotherapy.

(1) Background: The goal of this study is to evaluate psychological tolerance and health-related quality of life (QOL) in head and neck (HN) cancer patients treated with definitive accelerated radiotherapy (DART). (2) Methods: 76 recurrence-free patients eligible for the study, who were treated with DART in the CAIR-2 phase III clinical study (median of follow-up = 47 months), completed EORTC QLQ-C30 with the H&N35 module, Hospital Anxiety and Depression Scale (HADS) and Visual-Analog Scales (VAS) of pain in HN and the neck/arm areas. (3) Results: The most dominant symptoms measured with QLQ-C30 were as follows: fatigue (44/100), sleeplessness (39/100), financial problems (38/100) and pain (32/100). Within the H&N35, the highest scores were reported on the subscales of sticky saliva (60/100), mouth dryness (65/100) and increased intake of painkillers (50/100). Pain (VAS) was reported by 87% (HN area) and 78% (shoulder area) of the patients, with a mean score of 3/10. One-third of the patients reported depressive moods (HADS ≥ 15 points) with an average score of 12.5/42 p. The depressed group, who smoked more as compared to the non-depressed group before DART (96% vs. 78%) and required steroids treatment (85% vs. 58%) during DART, also scored significantly worse on 23 of the 35 subscales of QLQ-C30 and H&N35 and experienced more intense pain (VAS). Women and less-advanced patients scored better in several aspects of quality of life. (4) Conclusions: Patients treated with DART struggle with low quality of life and persistent treatment-related symptoms including constant pain. HNC survivors, especially those who are depressed, may require additional psychosocial, rehabilitation and medical intervention programmes.

A pill as a quick solution: association between painkiller intake, empathy, and prosocial behavior

Previous research has demonstrated a link between the administration of analgesic drugs and the reduction of empathy levels in humans. This apparent blunting effect of pain medication has been explained through shared neural mechanisms for the first-hand and the empathic experience of pain (simulation theory). Considering that analgesics are among the most consumed drugs in the world and the ability to empathize with others is fundamental to human social interactions, the aim of the present study was to investigate whether the typical day-to-day analgesic consumption rate in Austria and Germany is associated with a reduction in empathy and prosocial behavior. We therefore collected self-reports of analgesic consumption behavior as well as empathy for pain and prosocial behavior measures in an online survey (n = 940). Analyses revealed no significant association between the analgesic intake frequency and measures of empathy or prosocial behavior. However, liberal intake of analgesics (i.e. mind-set of “a pill is a quick solution”) was linked to lower empathic concern and helping behavior, which may hint towards a negative effect in people who take pain medication for non-pain related issues or episodes of low pain. Nevertheless, further research is needed to investigate the effects of analgesic drugs in high frequency users.

Brucella Olgularında Ağrı Prevalansı ve Yaşam Kalitesinin Değerlendirilmesi

Objective: Pain is an inevitable symptom in Brucellosis, which causes a wide clinical spectrum. In this study, we aimed to examine the effect of pain on presence, severity, localization, analgesic intake and quality of life in patients diagnosed with Brucella.
 Materail and Methods: Patients diagnosed with Brucella based on clinical and laboratory findings were included in the study. Age, gender, clinical stage of Brucella, organ involvement, serum C-reactive protein (CRP) level and standard tube agglutination test (STA) titer of the patients were recorded. The Brief Pain Inventory (BPI) and the Turkish Version of the World Health Organization Quality of Life Scale Short Form (WHOQOL-BREF-TR) were administered face-to-face to the patients.
 Results: The median age of 92 Brucella patients included in the study was 40.5 years. 54.3% of the patients were male and 45.7% were female. At admission, 57.6% were acute, 31.5% subacute, and 10.9% chronic. Organ involvement was present in 31.5% of the patients. At the time of diagnosis, 89.1% of the patients had pain complaints. Pain localization was most frequently in the knee, back, hip and shoulder, respectively. 51.1% of the patients were using nonsteroidal anti-inflammatory drugs (NSAIDs) at least once a day. There was no statistically significant correlation between age, disease stage, organ involvement, serum CRP level and STA titer and WHOQOL-BREF and VAS measurement values. WHOQOL-BREF Psychological (p=0.003) and WHOQOL-BREF Social (p=0.008) measurement values were found to be higher in women than men.
 Discussion and Conclusion : Pain is a common symptom in Brucella patients. Regardless of age, laboratory parameters and organ involvement, pain in Brucella patients should be questioned at all clinical stages. It affects the quality of life and may cause undesirable side effects by causing frequent painkiller intake.

Autologous Platelet-Rich Plasma in Clitoral Reconstructive Surgery After Female Genital Mutilation/Cutting: A Pilot Case Study.

Postoperative healing after clitoral reconstruction (CR) for female genital mutilation/cutting can be long and painful due to prolonged clitoral re-epithelialization time (up to 3 months). Autologous platelet-rich plasma (A-PRP) might reduce postoperative clitoral epithelialization time and pain. The authors assessed postoperative clitoral re-epithelialization time and pain after intraoperative clitoral administration of A-PRP. Five consecutive women underwent CR (Foldès technique) followed by the administration of A-PRP Regen Lab SA (Le Mont-sur-Lausanne, Switzerland) plasma and glue, injected inside and applied above the re-exposed clitoris, respectively. We recorded surgical complications, postoperative clitoral pain (visual analogue scale), painkiller intake, time to complete re-epithelialization, and the experienced subjective changes in sexual response and perception of their own body image referred by women. Sexual distress/dysfunction as well as the desire to be physically and symbolically "repaired" were the reasons behind women's requests for surgery. None of the women suffered from chronic vulvar or non-vulvar pain. All women achieved complete clitoral epithelialization by day 80, 3 women between day 54 and 70, and only 1 woman was still taking 1 g of paracetamol twice a day at 2 months postoperative. She had stopped it before the 3-month control. There were no short- or long-term complications. All women described easier access and stimulation of their clitoris as well as improved sexual arousal, lubrication, and pleasure and claimed to be satisfied with their restored body image. A-PRP could expedite postoperative clitoral epithelialization and reduce postoperative pain after CR after female genital mutilation/cutting.

Amino Acid-Enriched Formula for the Post-Operative Care of Extraction Sockets Evaluated by 3-D Intraoral Scanning.

Background: Hyaluronic acid and amino acids play an important role in the wound healing process, stimulating the development of the connective tissue and the activity and proliferation of fibroblasts. The aim of the present controlled clinical study was to evaluate the clinical efficacy of a topical gel formula containing hyaluronic acid and amino acids in terms of wound closure rate, painkiller intake, and patients’ reported pain and edema. Methods: This study included patients in need of a single tooth extraction. Patients were randomized into two groups with differing post-operative care regimens. Patients in the test group used the amino acid and hyaluronic acid-based gel, while the control group did not use any product. Each parameter was measured in both groups at different time points: immediately after surgery, and after 7, 14, 30, and 60 days. Results: A total of 40 patients (46.52 ± 9.84 years old) completed the observational period, and 40 extraction sockets were examined. After 7 days, the edema was significantly lower in the test group. The reported pain was lower in the test group without a significant difference, except for the first time point at 7 days. With the follow-up questionnaire, patients declared to have taken painkillers mainly during the first 7 days after surgery; however, the test group showed a lower need for painkillers than the control group. Conclusion: The post-operative and domiciliary use of an amino acid and hyaluronic acid-based gel for the management of soft tissue closure after tooth extraction is a valid coadjutant to reduce swelling, pain, and the need for painkillers. Additional studies are required to support the results of the present study.

Rapid response to galcanezumab and predictive factors in chronic migraine patients: A 3-month observational, longitudinal, cohort, multicenter, Italian real-life study.

A rapid response to preventive therapy is of pivotal importance in severely disabled patients with chronic migraine (CM) and diverse preventive treatment failures. This prospective, observational, multicenter real-life study aimed at investigating the effectiveness of galcanezumab in the first 3months of treatment of CM patients at 14 Italian headache centers. All consecutive adult patients with CM diagnosis with the clinical indication for galcanezumab were considered. We collected patients' baseline characteristics, monthly headache days, monthly painkiller intake, migraine clinical characteristics, and disability scale scores during a 1-month run-in period (baseline) and the first 3months of therapy. Possible predictive factors of treatment were considered. A total of 156 patients (82.4% female, aged 47.3±12.3years) were enrolled. The 65 (41.7%) patients with a consecutive ≥50% response rate (RR) in the 3months of therapy presented a lower body mass index (p=0.004) and more frequently presented unilateral migraine pain (p=0.002) and good response to triptans (p=0.003). Persistent conversion from CM to episodic migraine was observed in 55.8% (87/156) of patients. They more frequently presented a good response to triptans (p=0.003) and unilateral pain (p=0.046). At baseline, 131 of 156 (83.9%) patients presented medication overuse (MO). Of these, 61.8% (81/131) no longer displayed MO consistently during the 3months. These patients were more frequently responders to triptans (p=0.002) and less frequently suffered from gastrointestinal comorbidity (p=0.007). Unilateral pain, good response to triptans, and normal weight may be associated with a persistent positive response in the first 3months of therapy with galcanezumab in CM patients.

Efficacy and safety of 225Ac-DOTATATE targeted alpha therapy in metastatic paragangliomas: a pilot study.

PurposeIn this study, we aim to evaluate the efficacy and safety of 225AC-DOTATATE targeted alpha therapy in advanced-stage paragangliomas (PGLs).MethodsNine (6 males and 3 females) consecutive patients with histologically proven PGLs were treated with 225Ac-DOTATATE targeted alpha therapy (TAT) and concomitant radiosensitizer, capecitabine, at 8-weekly intervals up to a cumulative activity of ~ 74 MBq. The primary endpoint included evaluating therapy response and disease control rate (DCR) using the RECIST 1.1 criteria. Additional secondary endpoints comprised clinical response assessment using EORTC QLQ-H&N35 questionnaire, Karnofsky Performance Scale (KPS), Eastern Cooperative Oncology Group performance status (ECOG), analgesic score (AS), dose alterations of anti-hypertensive drugs (anti-HTN), and the safety and side-effect profile evaluation as per CTCAE criteria version 5.0.ResultsFollowing 225Ac-DOTATATE treatment, morphological response revealed partial response in 50%, stable disease in 37.5%, and disease progression in 12.5%, with a DCR of 87.5%. Similarly, the symptomatic response was remarkable, and anti-HTN drugs were stopped in 25% and reduced in 37.5%. Another significant finding in our study revealed a morphologic DCR of 66.6% (2/3) in patients who failed previous lutetium-177 peptide receptor radionuclide therapy (177Lu-PRRT). Regarding the KPS, ECOG, and AS performance scores, a notable improvement was observed post-225Ac-DOTATATE treatment. The QLQ-H&N35 symptom scores evaluated in seven H&N PGL patients showed significant improvement in all aspects. No improvement in sexual function was noted (P = 0.3559). Despite the significant reduction in the analgesic score post-treatment (P = 0.0031), the QLQ-H&N35 revealed only marginal significance concerning the intake of pain killers (P = 0.1723). No grade III/IV hematological, renal, and hepatological toxicities were noted.ConclusionThe evidence from this study suggests 225Ac-DOTATATE therapy is effective and safe in the treatment of advanced-stage PGLs and also reports a clear benefit even in patient’s refractory to the previous 177Lu-PRRT.Supplementary InformationThe online version contains supplementary material available at 10.1007/s00259-021-05632-5.

Oral Impacts of Aligners versus Fixed Self-Ligating Lingual Orthodontic Appliances

The aim of this prospective study was to compare a fixed lingual orthodontic appliance with a commonly used aligner system, focusing on oral impacts and speech disturbances, during the first 3 months of orthodontic treatment. Two groups of adults were evaluated: 21 treated with Invisalign® and 26 with In-Ovation L® lingual brackets. Health-related quality of life questionnaires were used to assess the oral impacts, and speech samples were collected for speech evaluation by professionals. The levels of pain and painkiller intake were similar, increasing on the first day, and decreasing at 3 months. Subtle injuries on the lip and cheeks were initially reported in the aligner group. Lingual patients experienced more discomfort in swallowing and opening the mouth, tongue injuries and food residues, even at 3 months. The consonants “s” and “z” were mainly affected in both groups immediately after appliance insertion, but more often in the aligner group. These speech disturbances recovered in the following 3 months. In conclusion, both groups reported disturbances in quality-of-life measures; however, patients wearing lingual appliances experienced more disturbances, which persisted after three months. Speech disturbances were slightly more pronounced in the aligner group and recovered after three months.

The Intake of Pain Medication among Dentists and Dental Assistants with Musculoskeletal Disorders in Germany

Background: Dentists (Ds) and dental assistants (DAs) have a high lifetime prevalence of musculoskeletal disorders (MSDs). In this context, it is assumed that they have an increased intake of substances such as pain medication. Currently, there exist no data on the use of medication among Ds and DAs with MSDs in Germany. Methods: The online questionnaire (i.e., the Nordic Questionnaire) analysed the medical therapies used by 389 Ds (240 f/149 m) and 406 DAs (401 f/5 m) to treat their MSDs. Results: Ds (28.3–11.5%) and DAs (29.4–10.3%) with MSDs took medication depending on the affected body region. A trend between the Ds and DAs in the intake of drug therapy and the frequency was found for the neck region (Ds: 21.1%, DAs: 28.7%). A single medication was taken most frequently (Ds: 60.0–33.3%, DAs: 71.4–27.3%). The frequency of use varied greatly for both occupational groups depending on the region affected. Conclusion: Ds and DAs perceived the need for medical therapies because of their MSDs. Painkillers such as ibuprofen and systemic diclofenac were the medications most frequently taken by both occupational groups. The intake of pain killers, most notably for the neck, should prevent sick leave.

Can Kinesio taping improve discomfort after mandibular third molar surgery? A systematic review and meta-analysis.

The purpose of this study was to evaluate whether Kinesio taping (KT) can improve patient discomfort after mandibular third molar surgery. This systematic review and meta-analysis was conducted according to the PICO strategy. We searched 4 databases for related articles. All controlled trials or randomized controlled trials that evaluated the application of KT after mandibular third molar surgery were included. Screening and article selection were carried out by two independent reviewers. The main evaluation indicators were facial swelling, pain, and trismus. All statistical analyses were conducted using Review Manager 5.3 software. This analysis included 8 articles. The combined results showed that compared with the control group, the postoperative application of KT significantly reduced pain in the early (early stage mean difference (MD), - 2.00; 95% confidence interval (CI), - 2.40 to - 1.60; P < 0.00001) and late (late stage MD, - 1.18; 95% CI, - 2.26 to - 0.11; P = 0.03) postoperative periods and, thus, reduced the intake of painkillers. KT also reduced facial swelling in the early and late postoperative periods (early stage standardized mean difference (SMD), - 1.34; 95% CI, - 1.99 to - 0.68; P < 0.0001; late stage SMD, - 0.31; 95% CI, - 0.51 to - 0.11; P = 0.002). In addition, the postoperative application of KT improved restricted mouth opening in the early and late postoperative periods (early stage MD, - 5.03mm; 95% CI, - 6.32 to - 3.74mm; P < 0.00001; late stage MD, - 3.42mm; 95% CI, - 5.31 to - 1.52mm; P = 0.0004). KT can significantly reduce postoperative pain, swelling, and trismus after impacted mandibular tooth extraction. Additional high-quality and rigorously designed randomized controlled trials should be conducted to verify these conclusions. KT is a low-cost, simple, effective nondrug therapy for the postoperative management of mandibular third molar extraction and has broad prospects for clinical application.

Effectiveness and Safety of CGRP-mAbs in Menstrual-Related Migraine: A Real-World Experience.

IntroductionMigraine shows a significantly higher prevalence in women, especially during reproductive age when menstrual-related hormonal fluctuations represent the most common migraine trigger. Indeed, over 50% of patients report a higher occurrence of migraine attacks during the perimenstrual window. Menstrual migraine attacks are consistently referred to as more disabling, less responsive to symptomatic treatments, longer in duration, and more prone to relapse than non-menstrual migraine attacks. Evidence strongly suggests that estrogen fluctuations are involved in migraine attacks worsening during the perimenstrual window through several mechanisms directly or indirectly involving the CGRP pathway. We aimed to evaluate whether mAbs blocking CGRP-ligand or receptor (CGRP-mAbs) could represent an effective and safe preventive treatment for menstrual migraine attacks in patients with menstrual-related migraine (MRM) with previous treatment failures.MethodsForty patients with MRM with at least three previous treatment failures received monthly CGRP-mAbs. At the baseline and after six CGRP-mAbs administrations, patients underwent to extensive interviews to assess frequency, duration, intensity, and responsiveness to painkiller intake of migraine attacks occurring during the perimenstrual window.ResultsAfter six administrations of CGRP-mAbs we observed a reduction of median menstrual migraine frequency (from 5 to 2 days per month), pain intensity (from 8/10 to 6/10), and attacks duration (from 24 to 8 h) (p < 0.001). Nevertheless, a significant increase in the percentage of responding to migraine painkillers was observed from 42.5% at baseline to 95% at T1 (p < 0.001).ConclusionsCGRP-mAbs could represent a safe and effective preventive therapeutic strategy able to reduce the disabling burden of menstrual migraine attack frequency, duration, intensity, and significantly improve the response to painkillers. These findings could be related to and further indirectly prove the greater influence of CGRP-mediated mechanisms in the pathophysiology of menstrual migraine attacks.Supplementary InformationThe online version contains supplementary material available at 10.1007/s40122-021-00273-w.

Galcanezumab for the prevention of high frequency episodic and chronic migraine in real life in Italy: a multicenter prospective cohort study (the GARLIT study)

BackgroundThe clinical benefit of galcanezumab, demonstrated in randomized clinical trials (RCTs), remains to be quantified in real life. This study aimed at evaluating the effectiveness, safety and tolerability of galcanezumab in the prevention of high-frequency episodic migraine (HFEM) and chronic migraine (CM) in a real-life setting.MethodsThis multicenter prospective observational cohort study was conducted between November 2019 and January 2021 at 13 Italian headache centers. Consecutive adult HFEM and CM patients clinically eligible were enrolled and treated with galcanezumab subcutaneous injection 120 mg monthly with the first loading dose of 240 mg. The primary endpoint was the change in monthly migraine days (MMDs) in HFEM and monthly headache days (MHDs) in CM patients after 6 months of therapy (V6). Secondary endpoints were the Numerical Rating Scale (NRS), monthly painkiller intake (MPI), HIT-6 and MIDAS scores changes, ≥50% responder rates (RR), the conversion rate from CM to episodic migraine (EM) and Medication Overuse (MO) discontinuation.ResultsOne hundred sixty-three patients (80.5% female, 47.1 ± 11.7 years, 79.8% CM) were included. At V6, MMDs reduced by 8 days in HFEM and MHDs by 13 days in CM patients (both p < .001). NRS, MPI, HIT-6 and MIDAS scores significantly decreased (p < .001). Ten patients (6.1%) dropped out for inefficacy and classified as non-responders. Patients with ≥50%RRs, i.e. responders, were 76.5% in the HFEM and 63.5% in the CM group at V6. Among CM patients, the V6 responders presented a lower body mass index (p = .018) and had failed a lower number of preventive treatments (p = .013) than non-responders. At V6, 77.2% of CM patients converted to EM, and 82.0% ceased MO. Adverse events, none serious, were reported in up to 10.3% of patients during evaluation times.ConclusionsGalcanezumab in real life was safe, well tolerated and seemed more effective than in RCTs. Normal weight and a low number of failed preventives were positively associated with galcanezumab effectiveness in CM patients.Trial registrationClinicalTrials.govNCT04803513.

Comparative Analysis of the Influence of Selected Physical Factors on the Level of Pain in the Course of Temporomandibular Joint Disorders.

Introduction Temporomandibular joints (TMJs) play a very significant function in the activity of the locomotor system of the masticatory system. But they are often a source of pain, myopathy, myoarthropathy, and malfunction of their surrounding or internal structures. The treatment of a patient's discomfort associated with masticatory system dysfunctions strongly depends on their cause. Aim of the Study. The objective of the study was to evaluate the impact of selected physical factors: LED light therapy with electromagnetic field and cryotherapy for the level of pain, in the treatment of patients suffering from temporomandibular disorders (TMDs). Materials and Methods The study included 60 patients of both genders with diagnosed TMD in a clinical trial. The participants were randomly divided into two groups. Each group consisted of 30 people and was subjected to separate therapies in which LED light therapy with electromagnetic field (MLT) and cryotherapy (CT) were applied. Results Having assessed the results of the author's own research in terms of analgesic activity, determined on the VAS scale during the daily routine activity of the mandible and its individual movements, in general, each of the studied groups demonstrated a considerable decrease in the level of the patients' perception of pain (<0.001). Having compared both the therapeutic methods used, a greater reduction in the level of perceived pain was achieved with MLT (p=0.002). The type of therapy used turned out to be the only significant factor for the magnitude of this reduction. Conclusions Conclusions based on the results of our own research indicate that the selected methods of treatment demonstrate an analgesic effect in terms of the overall discomfort in the course of TMD, and that they may be an alternative pain relief thereby reducing the patient's intake of painkillers.

Locking down the CGRP pathway during the COVID-19 pandemic lockdown: the PandeMig study.

ObjectivesThe COVID-19 pandemic and the consequent lockdown came as a storm disrupting people’s everyday life. This study aimed at observing whether the COVID-19 related lockdown influenced migraine frequency and disability in migraine patients on therapy with monoclonal antibodies inhibiting the CGRP pathway.MethodsIn this longitudinal observational cohort study, 147 consecutive patients receiving monthly administration of erenumab or galcanezumab were enrolled in four Italian headache centers. All patients filled a questionnaire concerning working and household settings, recent flu symptoms or COVID-19 diagnosis, and family loss due to COVID-19 infection. Monthly migraine days (MMDs), monthly painkiller intake (MPI), and HIT-6 disability relative to the first month of lockdown imposition (T-lock) and the month before (T-free) were also collected.ResultsFrom T-free to T-lock, the cohort displayed a reduction in MMDs (from 10.5 ± 7.6 to 9.8 ± 7.6, p = .024) and HIT-6 scores (from 59.3 ± 8.3 men reduced MPI more frequently than women (p = .005).Conclusions Our study observed that the lockdown impact to 57.8 ± 8.8, p = .009), while MPI resulted unchanged (from 11.6 ± 11.5 to 11.1 ± 11.7; p = .114). MMDs, MPI, and HIT-6 variations from T-free to T-lock did not differ according to work settings or household. Patients beyond the first 3 months of therapy presented less often a reduction in MMDs (p = .006) and on everyday life did not affect the migraine load in patients receiving monoclonal antibodies inhibiting the CGRP pathway. Patients in the first months of therapy experienced a greater improvement according to drug pharmacokinetics, while women more frequently needed rescue medications, possibly indicating presenteeism or cephalalgophobia.

Postoperative discomfort after implant placement according to the All-on-4 concept with or without Zygoma implants: A prospective clinical study.

The purpose of the study was to assess patients' postoperative discomfort after implantations according to the All-on-4 concept with and without using Zygoma implants. Three treatment groups were formed for this prospective study: All-on-4 rehabilitation in the maxilla (group 1, N=25), All-on-4 rehabilitation in the maxilla using at least two Zygoma implants (group 2, N=25), and All-on-4 rehabilitation in the mandible (group 3, N=20). Principal outcome parameters were postoperative pain (100mm VAS) and perceived swelling (100mm VAS). Also, the use of analgesics was documented. The worst postoperative pain of 21.3 (SD 18.9) VAS was observed in group 2, but there was no statistically significant difference between the groups (mixed ANOVA p=.791). The postoperative total intake of painkillers was significantly higher in group 2 than in the other groups (p<.001). On postoperative day 28, the mean pain scores in all groups declined to values below 5 VAS. Postoperative perceived swelling in group 2 was significantly more severe than it was in group 1 and 3 (p<.001). The use of Zygoma implants in All-on-4 surgical interventions had an essential effect on postoperative swelling, but less so on postoperative pain. The slightly increased, but statistically not significantly different postoperative pain in group 2 was compensated by an overall higher postoperative intake of painkillers compared to the other groups.

Comparison of Pain Perception in Patients Affected by Cleft and Cranio Facial Anomalies Treated With Traditional Fixed Appliances or Invisalign.

The objective of this prospective study was to compare the difference in pain perception between treatment with aligners (AL) and fixed appliances (FA) in patients affected by cleft and craniofacial anomalies (CFA). The sample consisted of 100 syndromic caucasian patients affected by various CFA from 2 different hospitals. Fifty patients treated with AL were matched for sex, age, and CFA with a control sample of 50 patients treated with FA. A modification of the Mc Gill Pain Questionnaire was adapted to our needs. Statistical differences were found. Aligners induced more tightness and tension than FA, while FA induced more pain descriptors and patients reported a higher intake of painkillers. The results of this study documented a higher pain perception with FA than with AL in patients affected by CFA. The higher sensitivity to pain in cleft and craniofacial patients with fixed treatment could be related to their higher prior sensitization, given the past surgeries and orthodontic treatments. Thus, this study might suggest that Invisalign treatment might be a further interesting treatment option for patients with cleft in order to reduce their burden of orthodontic pain.

Опыт применения препарата Арника монтана С9 (БУАРОН) у детей после операции аденотомии

The efficacy of Arnica Montana C9 (BOIRON) during the recovery period after adenotomy in 60 children aged 3 to 10 years was evaluated. All patients were randomly divided into 2 groups for further comparison. Each was composed of 30 patients. Patients of the control group were prescribed standard therapy: a sparing diet and regimen for 5 days, nasal vasoconstrictor drugs (nazivin 0.025% – 0.05%) at an age dosage of 5 days, inside-Nurofen at an age dosage (with pain in the throat and increased body temperature). Children of the main group received standard therapy + Arnica Montana C9 (BOIRON). Reception of the drug Arnica Montana C9 (Boiron) began from the second day after adenotomy with a dosage of 5 granules 4 times a day, from the 3rd to the 10th day-5 granules 3 times a day. Complaints and objective examination data were analyzed during 4 visits-observation by a doctor: on the second day after adenotomy (1st visit), on the 4th day (2nd visit) and on the 10th day after surgery (3rd visit), as well as 1 month after the end of therapy (4th visit). The study made it possible to draw a conclusion about the manifestation of positive changes in clinical indicators in children of the main group (reduction of pain intensity and intoxication, improvement of nasal breathing) on the 4th day after adenotomy relative to the control group. There was a significant decrease in the intake of painkillers in the group of children receiving Arnica Montana C9 (BOIRON). Given the result, we can talk about the possibility of reducing the drug load in patients. Thus, the inclusion Of Arnica Montana C9 (BOIRON) in the therapy of patients after adenotomy can lead to a significant reduction in the recovery period.

Predicting the efficacy of surgery for pain relief in patients with alcoholic chronic pancreatitis

BackgroundRecurrent pain is the most disabling complication in patients with chronic pancreatitis. Pancreatic surgery is currently considered as last-resort therapeutic option. The aims of this study were to assess pancreatic surgery performance for chronic pain in patients with alcoholic chronic pancreatitis and to determine factors predictive of therapeutic response. MethodsAll patients with chronic pancreatitis who underwent pancreatic surgery for chronic pain were included and divided into 2 groups according to the cause of chronic pancreatitis: alcoholic and any other chronic pancreatitis causes as the control group. Alcohol, tobacco, and painkiller intake, quality of life data 6 months and 1 year after surgery, and morphological and pathological features were analyzed. ResultsFifty patients were included in the alcoholic chronic pancreatitis group and 16 patients in the control group. Smoking cessation before pancreatic surgery was achieved in 40% of the alcoholic chronic pancreatitis group compared with 73% of the control group (P = .005). Histological analysis revealed a higher prevalence of hypertrophic nerves and perineural inflammation in the alcoholic chronic pancreatitis group than in the control group (P = .03 and P = .04 respectively). In multivariate analysis, in the alcoholic chronic pancreatitis group, factors predictive of 6-month narcotic use cessation were surgery performed within a maximum of 2 years after chronic pancreatitis diagnosis (odds ratio = 4.228 [1.04–17.17]) and postoperative smoking cessation (odds ratio = 3.561 [1.021–12.41]); at 1 year, only smoking cessation was predictive of narcotic use cessation (odds ratio = 11.33 [2.677–47.98]). ConclusionIn patients with alcoholic chronic pancreatitis undergoing surgery for chronic pain, narcotic use cessation and improved quality of life depend on early surgery and complete smoking cessation.